If the Affordable Care Act (ACA) is overturned in California v. Texas,
nearly 20 million Americans would lose health insurance coverage, and access to care and financial security could also decline. States and providers would face significant financial distress as federal spending and reimbursement shrink.
If the ACA is overturned and its consumer protections eliminated, the associated increases in household costs would fall heavily on families with low and moderate incomes and people with significant health care needs.
Following the ACA’s implementation in 2014, new mothers were less likely to report having unmet health care needs because of cost and being very worried about paying their medical bills, and they were more likely to report they saw a general doctor and received a flu vaccine in the previous 12 months.
This brief offers a snapshot of how the COVID-19 recession affected households between late April and mid-July, leaving three million adults without employer-sponsored health insurance coverage and two million adults uninsured. These coverage losses have been concentrated among men, Hispanic adults, younger adults, and adults who have not attended college.
In 2017–18, 2.2 million mothers and 2.2 million fathers living with young children ages five and younger were uninsured, a 40 percent decline in uninsurance since 2013, following implementation of the major coverage provisions of the ACA.
Between 2013 and 2016, children’s uninsurance decreased, their Medicaid/Children’s Health Insurance Program (CHIP) participation rate increased, and the number of children who were eligible for Medicaid/CHIP but uninsured declined. But these gains stalled in 2017 and 2018, as children’s uninsurance increased, and program participation decreased relative to 2016 levels.
Changes in marketplace premium prices are correlated with shifts in enrollment among metal tiers. Although silver plans remained the most popular, the normally cheaper bronze plans became more popular, which is significant because bronze-level coverage potentially exposes consumers to higher out-of-pocket costs for substantial medical needs.
